Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | DR.0067025 | CO |
NPI | 1851746739 |
---|---|
Provider Name | Dr. Tamara Itzel Martinez |
First Address | Denver, CO 80238 |
Second Address | Denver, CO 80238-3324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2016 |
Last Update Date | 20/01/2022 |